Dirty Old London: 30 Days of Filth: Day 17

‘Doctors actively explored the worst parts of the capital. They sought out typhus cases and entreated landlords to fix windows (broken sash windows were a major factor in poor ventilation), limewash walls (i.e. apply disinfectant) and generally cleanse foetid apartments.’

Throughout this month, Lee Jackson reveals the background to Dirty Old London: The Victorian Fight Against Filth. The Victorians invented ‘sanitary science’ – the study of public health, dirt and disease – and were obsessed with sewers, sanitation and cleanliness. Why, then, did Victorian London remain so notoriously filthy?

Day 17: The London Fever Hospital

There were systematic attempts to cleanse London’s slums even before the cholera epidemic of 1831. The evangelical charity, The Society for Bettering the Condition and Increasing the Comforts of the Poor, embarked on one such scheme in 1801.

The Society, surveying the latest medical literature, became convinced that a separate London hospital for typhus patients would profoundly benefit the poor. The work of Dr. John Haygarth in Chester in the 1790s, and a dedicated ‘House of Recovery’ established in Manchester, seemed to prove that isolating typhus patients, and cleansing their dwellings, dramatically reduced the virulence of typhus outbreaks – and typhus was notoriously rife in the London slums.

The goal, however, was not only to treat patients but to keep track of where typhus was most prevalent, based on admission records. The hospital would then cleanse both the places where the fever was present and where it was ‘likely to appear’. To this end, with the hospital building still in the planning stage, doctors actively explored the worst parts of the capital. They sought out typhus cases and entreated landlords to fix windows (broken sash windows were a major factor in poor ventilation), limewash walls (i.e. apply disinfectant) and generally cleanse foetid apartments. Case studies were published which showed how the poor struggled to find treatment, and, in the process, doubtless spread the disease even further:

No. 1. Nicholas Terry, his wife, and two small children, reside in a narrow room, on the ground floor, in Lumley’s Rents, near Chancery-lane. They had very lately arrived from Ireland, when the wife was attacked by fever, from which she partially recovered in a few days ; but, at the end of about a fortnight, relapsed; and, at the same time, the man became affected in a violent degree. From the closeness of the room (occasioned chiefly by the impossibility of opening the windows) and the evident infectious nature of the disease, none of their neighbours would venture to their assistance … Medical advice being at length applied for, and the violence of the man’s fever, with the other circumstances of his situation, rendering it evident that no effectual relief could be afforded to him at home, his relation was advised to obtain admission for him into an hospital; and one was particularly mentioned, which was said to admit fever-patients at all times without recommendation, as accidents. Thither the man was carried immediately in a hackney-coach; but finding to his great mortification, that he had been mis-informed as to the facility of gaining admission, he was obliged to return in the same vehicle, in which he remained nearly three hours …’

When the victims’ rooms were limewashed and purified, the fever died out. The doctors concluded that a programme of cleansing worked wonders.

Unfortunately, the hospital lacked the funds to continue such proactive sanitary efforts. Yet the evidence from the register of admissions would, indeed, reveal the worst-afflicted alleys and courts. The hospital, therefore, adopted the strategy of gratuitously cleansing any rooms in which their patients had lived; and repeatedly asking parishes and poor law authorities to address the broader question of the overall sanitary condition of such buildings. But parish vestries, notoriously penny-pinching, were loathe to ‘burden the rates’ with such work.

The doctors’ efforts would, at least, have one important legacy. Dr. Thomas Southwood Smith became the Fever Hospital’s chief physician in 1824. It would be his experience of fever patients – and the hospital’s intervention in their homes – that profoundly influenced his friend Edwin Chadwick, and the ‘sanitary movement’ of the 1840s.